Increased risk of blood transfusion in patients with diabetes mellitus sustaining non-major burn injury
•Compared to non-diabetics, burn patients with diabetes mellitus were older, had more comorbidities, more surgeries and more wound infections.•Factors associated with receiving PRBC in burns include burn size, admission haemoglobin, number of surgeries, comorbid burden and infection.•Diabetes was fo...
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| Published in: | Burns 2020-06, Vol.46 (4), p.888-896 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | eng |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •Compared to non-diabetics, burn patients with diabetes mellitus were older, had more comorbidities, more surgeries and more wound infections.•Factors associated with receiving PRBC in burns include burn size, admission haemoglobin, number of surgeries, comorbid burden and infection.•Diabetes was found to be associated with increased risk of PRBC transfusion despite adjusting for those factors.•As burn size increases, the risk of requiring PRBC transfusion increases at a higher rate in patients with diabetes.
Due to the increased mortality and morbidity associated with blood transfusion, identifying modifiable predictors of transfusion are vital to prevent or minimise blood use. We hypothesised that burn patients with diabetes mellitus were more likely to be prescribed a transfusion. These patients tend to have increased age, number of comorbidities, infection risk and need for surgery which are all factors reported previously to be associated with blood use.
To determine whether patients with diabetes mellitus who have sustained a burn ≤20% total body surface area (TBSA) are at higher risk of receiving red blood cell transfusion compared to those without diabetes mellitus.
This was a retrospective cohort study including patients admitted to the major Burns Unit in Western Australia for management of a burn injury. Only the first hospital admission between May 2008 to February 2017 were included.
Among 2101 patients with burn injuries ≤20% TBSA, 48 (2.3%) received packed red blood cells and 169 (8.0%) had diabetes. There were 13 (7.7%) diabetic patients that were transfused versus 35 (1.8%) non-diabetic patients. Patients with diabetes were 5.2 (p = 0.034) times more likely to receive packed red blood cells after adjusting for percentage TBSA, haemoglobin at admission or prior to transfusion, number of surgeries, total comorbid burden and incidence of infection. As percentage TBSA increases, the probability of packed red blood cell transfusion increases at a higher rate in DM patients.
This study showed that diabetic patients with burn injuries ≤20% TBSA have a higher probability of receiving packed red blood cell transfusion compared to patients without diabetes. This effect was compounded in burns with higher percentage TBSA. |
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| ISSN: | 0305-4179 1879-1409 |